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倒刺缝线与标准缝线在腹壁成形术和乳房缩小成形术患者伤口美观方面的比较

A Comparison of Barbed Sutures and Standard Sutures with regard to Wound Cosmesis in Panniculectomy and Reduction Mammoplasty Patients.

作者信息

Aliano Kristen, Trostler Michael, Fromm Indira Michelle, Dagum Alexander, Khan Sami, Bui Duc

机构信息

Department of Plastic Surgery, University of Texas Medical Branch, Galveston, TX, USA.

Department of Plastic Surgery, Stony Brook University Hospital, Stony Brook, NY, USA.

出版信息

Plast Surg Int. 2016;2016:7590396. doi: 10.1155/2016/7590396. Epub 2016 Nov 29.

Abstract

Cosmesis is a vital concern for patients undergoing plastic and reconstructive surgery. Many variations in wound closure are employed when attempting to minimize a surgical scar's appearance. Barbed sutures are one potential method of achieving improved wound cosmesis and are more common in recent years. To determine if barbed sutures differ from nonbarbed in wound cosmesis, we conducted a single-blinded, randomized, controlled trial of 18 patients undergoing bilateral reduction mammoplasty or panniculectomy. Patients were their own controls, receiving barbed sutures on one side and standard sutures on the contralateral side. Surgical scars were evaluated postoperatively by patient preference self-assessment and an observer. Ten patients were evaluated at 3 months postoperatively, yielding a mean Stony Brook Scar Evaluation Scale (SBSES) rating of 4.4 for barbed suture and 3.5 for regular suture ( = 0.15). At 6 months, 8 patients performed self-assessment to determine their preference; 4 preferred the barbed sutures, 1 preferred the regular sutures, and 3 had no preference. Further research with larger sample sizes is needed to determine if barbed sutures convey any advantage over standard sutures in wound healing. However, our results suggest that barbed sutures are a reasonable alternative to standard sutures particularly with regard to wound cosmesis.

摘要

对于接受整形和重建手术的患者来说,美观是一个至关重要的问题。在试图尽量减少手术疤痕外观时,会采用多种伤口闭合方式。倒刺缝线是一种可能改善伤口美观的方法,近年来更为常见。为了确定倒刺缝线在伤口美观方面是否与非倒刺缝线不同,我们对18例接受双侧乳房缩小术或腹壁成形术的患者进行了一项单盲、随机、对照试验。患者自身作为对照,一侧使用倒刺缝线,对侧使用标准缝线。术后通过患者偏好自我评估和观察者对手术疤痕进行评估。术后3个月对10例患者进行评估,倒刺缝线的平均石溪疤痕评估量表(SBSES)评分为4.4,普通缝线为3.5(P = 0.15)。在6个月时,8例患者进行自我评估以确定他们的偏好;4例更喜欢倒刺缝线,1例更喜欢普通缝线,3例无偏好。需要进行更大样本量的进一步研究,以确定倒刺缝线在伤口愈合方面是否比标准缝线具有任何优势。然而,我们的结果表明,倒刺缝线是标准缝线的一种合理替代方案,特别是在伤口美观方面。

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本文引用的文献

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Bidirectional barbed sutures for wound closure: evolution and applications.用于伤口闭合的双向倒刺缝线:演变与应用
J Am Col Certif Wound Spec. 2009 May 23;1(2):51-7. doi: 10.1016/j.jcws.2009.01.002. eCollection 2009 Apr.

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